Connecticut's health exchange sent outreach workers to the Milford Oyster Festival to get people to sign up for health insurance.

Jeff CohenWNPR

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Originally published on September 13, 2013 7:12 am

All across Connecticut, you can see billboards and TV ads, hear radio spots and get pamphlets about how to get insurance under the new health care law starting Oct. 1.

But the state is also using less traditional, and more expensive, ways to get the word out.

At state beaches this summer, outreach workers handed out tubes of sunscreen that said, "Get Covered." The state is opening up Apple-like storefronts. And outreach workers have fanned across the state to talk with people attending fairs and shows, like the America's Most Wanted rap concert featuring superstars Lil Wayne and T.I.

Papilon Ferreiras, 21, was at the concert. He says he works about 35 hours a week at Taco Bell and would like health insurance.

"Who wouldn't? Who wouldn't like health insurance?" he says.

This is where Emanuela Cebert, an outreach worker, sees an opening. She walks up to Ferreiras, tablet computer in hand.

"If I had a way for you to get more affordable health insurance or health insurance in general, would you want to learn more about it?" she asks.

"I'll look into it. Not today. But I'll look into it," Ferreiras answers.

So Cebert tells him she can get his information and contact him in October, when Connecticut's marketplace starts selling insurance under the Affordable Care Act.

"It's pretty hard to communicate effectively without investing some," he says. "We invested in a lot of other programs in order to promote them."

The outreach is heating up now, even though people can't officially sign up until October. Coverage begins in January.

Connecticut is one of 16 states and the District of Columbia setting up their own health insurance marketplaces. Under the Affordable Care Act, they get access to federal marketing money.

The outreach work isn't easy. People often people walk right by Cebert and her colleagues. But if the health care expansion is going to survive, successful outreach is important.

"We're gonna be at Miranda Lambert and Dierks Bentley," Counihan says. "We're going to be at the Rockstar Energy Drink Uproar Festival. We're going to be at John Mayer and Phillip Phillips."

It's about more than raw numbers. It's about the particulars of who signs up. "It has to be broad and comprehensive," he continues. "If we narrowed this, say, to the Hartford Pops Festival, or the Hartford Jazz Festival, we will get a slim demographic which doesn't adequately reflect our state."

A few weeks later, Counihan's workers were at the Milford Oyster Festival and its shucking competition. The goal was to reach an older, more suburban crowd.

Robert Harrington was there. He says he could get health insurance through his job, but he doesn't. It's too expensive, and he makes a calculation.

"At $100 a week. You know, do I pay health insurance [or] do my kids eat?" he asks.

Now, he doesn't have much of a choice. He doesn't like President Obama, and he doesn't like Obamacare. But he doesn't want to be penalized for being uninsured.

"You know, I got to do what I got to do. I don't want to get fined. 'Cause it's a tax!" he says.

And then there's Gary Mott. He's a bathtub refinisher with insurance, but he worries about the $10,000 deductible for his and his wife's policy.

"For both of us altogether it's about $450 so we're good right now, as far as premiums go," he says. "But that deductible, if one or both of us gets sick we're in trouble. That's how people end up losing their homes and such."

So Mott could be one of the people who finds an option in Connecticut's marketplace. Exchange head Counihan says he's hoping to enroll about 100,000 people in the first year alone.

The country is gearing up for the launch of the federal health care law's requirement for almost everyone to have health insurance. Connecticut and a handful of other states are taking advantage of federal money to help them advertise the health insurance options out there.

As Jeff Cohen, of member station WNPR reports, Connecticut has hired throngs of workers to go to some pretty interesting places and spread the word.

JEFF COHEN, BYLINE: In Connecticut, they're taking Obamacare to the people. They've got the standard billboards, television and radio ads, and pamphlets. But there's more. At beaches, they're handing out tubes of sunscreen that say: Get Covered. They're opening up Apple-like storefronts. And across the state, they're going to fairs and concerts like this, the America's Most Wanted Rap Concert featuring superstars L'il Wayne and T.I.

PAPILON PAP HAZE FERREIRAS: This is Pap Haze, by the way. I'm 21 but I'll be 22. No health insurance, still living healthy.

COHEN: That's Papilon Ferreiras. He goes by Pap Haze, and he says he works about 35 hours a week at Taco Bell.

FERREIRAS: I make $8.30 an hour, slaving it. But I do it for the fun of it.

COHEN: You don't have health insurance. Would you like health insurance?

FERREIRAS: Yeah, all day. Who wouldn't? Who wouldn't like health insurance?

COHEN: This is when Emanuela Cebert sees an opening.

EMANUELA CEBERT: OK, listen....

COHEN: Cebert is an outreach worker. She's got a tablet computer with her.

CEBERT: If I had a way for you to get more affordable health insurance, would you want to learn more about it?

FERREIRAS: I'll look into it.

CEBERT: Yeah, would you?

FERREIRAS: Not today. But I'll look into it.

CEBERT: I'll get your information, either email, phone number, or what have you. And then, when this all starts in October, somebody will contact you so you can get health insurance.

FERREIRAS: All right, that's cool.

COHEN: Not far away is Kevin Counihan. Counihan is the executive director of Access Health CT, the state's healthcare exchange. He's got $15 million in federal money to spend on marketing.

KEVIN COUNIHAN: For something like this, which is the biggest expansion of health insurance in 50 years, it's pretty hard to communicate effectively without investing some. We invest in a lot of other programs in order to promote them. We did in Medicare Part D. We did in Medicare. We have in Social Security. All these require some investment.

COHEN: Connecticut is one of 16 states and the District of Columbia setting up its own health insurance marketplace under the Affordable Care Act. And that means it has access to federal marketing money to reach the state's uninsured. The outreach is staring now, even though you can't officially sign up until October 1st and coverage begins in January.

Sometimes, the concertgoers are receptive, like Pap Haze. Sometimes they keep walking. And sometimes, they're just having too much fun to talk health care.

UNIDENTIFIED WOMAN: You know Obamacare legislation, the Affordable Care Act is going through in 2014?

COHEN: So, it's not always easy to do this outreach. But if the health care expansion is going to survive, the outreach is important. And it's about more than the numbers. It's about demographics.

COUNIHAN: We're going to be at Miranda Lambert and Dierks Bentley. We're going to be at the Rockstar Energy Drink Uproar Festival. It has to be broad and comprehensive. If we narrowed this to, say, the Hartford Pops Festival, we will get a slim demographic which doesn't adequately reflect our state.

UNIDENTIFIED MAN #2: Ready, get set, go.

COHEN: A few weeks later, Counihan's operation was at the Milford Oyster Festival, with a shucking competition. The goal was to reach an older, more suburban crowd.

UNIDENTIFIED MAN #3: Hi. How are you?

ROBERT HARRINGTON: Good.

UNIDENTIFIED MAN #3: Would you like to learn more about Access Health?

HARRINGTON: Yeah.

UNIDENTIFIED MAN #3: Well, we're the new health insurance marketplace in the state of Connecticut...

COHEN: Robert Harrington could get health insurance through his job, but he doesn't - it's too expensive.

HARRINGTON: Hundred dollars a week, you know, I got to eat. Do I pay health insurance? Do my kids eat?

COHEN: Now, he doesn't have much of a choice. He doesn't like President Obama. And he doesn't like Obamacare. But he doesn't want to be penalized for being uninsured.

HARRINGTON: You know, I got to do what I got to do. You know, I don't want to freaking get fined. 'Cause it's a tax.

COHEN: And then there's Gary Mott. He's a tub refinisher with insurance, but he worries about his $10,000 deductible.

GARY MOTT: For both of us altogether, it's about $450. So we're good right now, as far as the premiums go - but that's deductible. If one or both of us gets in - you know, really sick, we're in trouble. That's how people end up losing their homes and stuff. So I'm looking for something that I could afford 'cause I'm self-employed. I'm not a rich man; getting by.

COHEN: So Mott could be one of the people who find an option in Connecticut's marketplace. Exchange head Kevin Counihan says he's hopes that 100,000 people will enroll in the first year alone.

For NPR News, I'm Jeff Cohen in Hartford.

SIEGEL: And that story is part of a collaboration of NPR, WNPR and Kaiser Health News. Transcript provided by NPR, Copyright NPR.